Table of Contents
Introduction xi
1 The Coming Flood of Genomic Messages 1
What is genomic information?
What is genomic privacy?
Why is DNA like a book or a recipe?
What is genomic medicine and why might it change how we think?
Can we strike a "genetic balance" in our health care?
2 Personalized (Genomic) Medicine 23
What is a genetic family history and why does it matter?
How can personalized medicine become impersonal medicine?
How did genetically isolated populations help DNA researchers?
Why will genomic medicine require electronic health records?
3 Nature, Nurture, and the Microbiome 45
How do twins help us understand that it's nature and nurture?
How do genomics and the environment affect the fetus?
How do genomics and the environment work in diabetes?
How does your microbiome affect your health?
4 Pharmacogenomics 67
How have racism and stereotyping plagued genomics?
What does warfarin tell us about pharmacogenomics?
How do foods and genes interact?
Why is it unlikely that your physician will use your genome to prescribe drugs?
What will pharmacogenomics look like in the future?
5 Reprogenomics 87
Why is reprogenomics based on genetic relationships?
What are the social policy issues in reprogenomics?
What new issues do embryo and stem cell research create?
Is regulation of the fertility industry necessary?
6 Genomic Messages from Fetuses 111
How does prenatal diagnosis work?
What are karyotypes and microarrays?
Is whole-genome sequencing of fetuses in our future?
Are new consent models needed for whole-genome sequencing in fetuses?
7 Genomic Messages from Newborns and Children 139
When is whole-genome sequencing of sick children indicated?
What is newborn screening and how does it work?
Why shouldn't all newborns have their DNA sequenced?
8 Cancer Genomics 161
Is cancer a genetic disease?
How can the "hallmarks of cancer" suggest novel treatments?
Why does cancer sequencing hold promise for personalized medicine?
How is cancer treatment evolving?
What can breast cancer teach us?
9 Genomic Privacy and DNA Data Banks 191
How do "big data" and "big DNA banks" affect our privacy?
How do criminal DNA data banks work?
How do commercial DNA data banks work?
How can we make informed consent to DNA data banking meaningful?
Can companies patent our DNA?
10 Genomics Future 217
How does genomics affect how we see death and our future?
What are "species-endangering" experiments?
What are "posthumans" and "transhumans"?
How can we tell the difference between genomics fact and fantasy?
How can individuals influence the genomics research agenda?
Acknowledgments 243
Appendix A DNA and the Human Genome 245
Appendix B Limitations of Screening Tests 249
Notes 253
Glossary 275
Index 279
About the Authors 288